Friday, November 27, 2015

Civil Rights movement's often-overlooked impact on health care

Prize-winning historian and author John Dittmer recounts the work of Civil Rights-ear health care activists and the struggle to make health care a human right.

Civil Rights movement's often-overlooked impact on health care

People carry civil rights signs as they gather in Washington, D.C. before Martin Luther King Jr.´s "I Have a Dream" speech on Aug. 28, 1963. (AP Photo)
People carry civil rights signs as they gather in Washington, D.C. before Martin Luther King Jr.'s "I Have a Dream" speech on Aug. 28, 1963. (AP Photo)

The March on Washington for Jobs and Freedom on Aug. 28, 1963, remembered primarily for the Rev. Martin Luther King Jr.'s “I Have a Dream” speech, was part of an era that forced the nation to become more fully aware of racial discrimination – including discrimination in health care, an achievement that in hindsight may be among the most significant of the movement for Civil Rights.  Prize-winning historian and author John Dittmer  recounts the work of health care activists and the struggle to make health care a human right in his 2009 book The Good Doctors: The Medical Committee for Human Rights and the Struggle for Social Justice in Health Care. I interviewed him about the Medical Committee for Human Rights, which was founded by Philadelphia physician and activist Walter Lear.

Janet Golden: How did the Medical Committee for Civil Rights (MCCR), the forerunner of the Medical Committee for Human Rights (MCHR), get started and come to be involved in the March on Washington?

John Dittmer: MCHR was the brainchild of physician Walter Lear (whose papers are now at the University of Pennsylvania library). Long before civil rights became fashionable, Lear was actively involved in racial matters, particularly racial inequality in health care. He formed the Medical Committee for Civil Rights specifically to attack the American Medical Association’s policy of refusing to require its southern members to integrate, thereby denying African American physicians hospital privileges throughout the Deep South. A small group of doctors demonstrated on the Atlantic City boardwalk at the AMA national convention in 1963. It was probably the first public protest by doctors acting as a group.

After the demonstration, which received widespread publicity, Lear set about arranging a coalition of health care groups to participate in the March on Washington. As a result, more than 200 health care workers, including representatives from the National Medical Association (which represented African American physicians) and the American Nurses Association, marched under the MCCR banner.

Lear wanted to devote full time to MCCR, and was disappointed when his physician base did not raise the funds to do so. By the fall of 1963, MCCR was in debt, and Lear shut down the organization. It should be added that by the fall of 1963 civil rights was no longer fashionable among Americans. The death of John Kennedy cast a pall over the entire country. Movement activity would not intensify until early 1964. By that time Lear had taken a job in Philadelphia, and would not be among the founders of the successor organization, the Medical Committee for Human Rights.

Janet Golden: How did the MCHR get started?

John Dittmer: There are lots of creation stories concerning MCHR. For me the most plausible centers around Tom Levin, a New York psychoanalyst who, like Walter Lear, had been South as a civil rights activist in the early 60s. In the summer of `1964, civil rights forces in Mississippi, led by the Student Nonviolent Coordinating Committee, (SNCC), planned what would later be called “Freedom Summer.” They invited upwards of a thousand college students, most of them from the North, to spend their summer vacations in Mississippi working with the Movement in a variety of ways. There were very few African American doctors practicing in Mississippi, and only a handful of them would treat civil rights workers. White physicians generally would have nothing to do with the “outside agitators.” So SNCC contacted Levin, asking him to organize a group of doctors and other health care workers to spend a week or two in Mississippi, providing health care for the volunteers and long-time activists. Levin called a group together in New York, and MCHR was born.

MCHR did provide services for civil rights workers. Most were healthy, and did not need much attention. One of the doctors’ most valuable contributions was providing counseling for veteran Movement workers suffering what was then called “burnout” (and later PTSD). The mere presence of a physician at a project, or visiting movement people who had been jailed, seemed to have a calming effect.

The key person in the MCHR effort during the summer was Robert Smith, a African American Jackson physician known as “the doctor to the movement.” Smith provided orientation for every medical volunteer who came to Mississippi that summer, help set up appointments, and counseled physicians as well as volunteers. In short, without Smith the MCHR effort never would have gotten off the ground in Mississippi.

The most important lesson learned by the 100 medical volunteers was that the African American population of Mississippi by and large received no health care. Many poor African Americans had never seen a physician. White doctors’ offices were all segregated, and many white doctors refused to treat African Americans. Public health was a disgrace. So after the summer MCHR decided to become a permanent organization, and in 1965 established a southern field office in Jackson, Mississippi under the leadership of a young psychiatrist named Alvin Poussaint. These were modest efforts to provide medical care for poor African Americans. The breakthrough came when H. Jack Geiger, who had been a medical volunteer during the summer, had raised funds for a small clinic in the Mississippi Delta. Out of that experience came the idea for the comprehensive community health center movement. Geiger’s dream resulted in a program that now provides health care to 20 million needy Americans.

MCHR expanded into Alabama and Louisiana in the mid-1960s. One of the most valuable services provided by MCHR was “Medical Presence.” Whenever there was a demonstration, an MCHR team would be on the scene, providing first aid for workers who were beaten during a demonstration, and serving as observers of whatever lawbreaking transpired. In so doing the MCHR members provided invaluable moral support in addition to medical care. The vital contributions of MCHR are detailed in my book.

Janet Golden: What lessons can we draw from the history of the MCHR?

John Dittmer: I believe that MCHR awakened the nation’s consciousness to racial discrimination in health care. All the evils were in place by 1964, but most Americans were unaware and therefore unconcerned about the health of African Americans. Even civil rights activists, intent on registering African Americans to vote and desegregating public facilities, did not have health care on their radar screen until MCHR came along. Although much remains to be done, one can make the case that it was in the area of health care, more so than in any other aspect of life, that the civil rights movement (read health care activists) succeeded in addressing a major human rights problem.

Janet Golden, a Rutgers University history professor, specializes in the histories of medicine, childhood and women.

Read more about The Public's Health.

Professor of history, Rutgers University-Camden
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What is public health — and why does it matter?

Through prevention, education, and intervention, public health practitioners - epidemiologists, health policy experts, municipal workers, environmental health scientists - work to keep us healthy.

It’s not always easy. Michael Yudell, Jonathan Purtle, and other contributors tell you why.

Michael Yudell, PhD, MPH Associate Professor, Drexel University School of Public Health
Jonathan Purtle, DrPH, MSc Assistant Professor, Drexel University School of Public Health
Janet Golden, PhD Professor of history, Rutgers University-Camden
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